Three-year mortality among alcoholic patients after intensive care: a population-based cohort study
1 Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes alle 43-45, Aarhus N, 8240, Denmark
2 Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Skejby Hospital, Brendstrupgårdsvej 100, Aarhus N, 8240, Denmark
3 Department of Anaesthesiology and Intensive Care, Aarhus Hospital, Aarhus University Hospital, Nørrebrogade 44, Aarhus C, 8000, Denmark
4 Department of Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala S-751 85, Sweden
5 Department of Medicine V (Hepatology and Gastroenterology), Aarhus University Hospital, Aarhus Hospital, Aarhus Hospital, Nørrebrogade 44, Aarhus C, 8000, Denmark
Critical Care 2012, 16:R5 doi:10.1186/cc10603Published: 8 January 2012
Alcoholic patients comprise a large proportion of patients in intensive care units (ICUs). However, data are limited on the impact of alcoholism on mortality after intensive care.
We conducted a cohort study among 16,848 first-time ICU patients between 2001 and 2007 to examine 30-day and 3-year mortality among alcoholic patients. Alcoholic patients with and without complications of alcohol misuse (for example, alcoholic liver disease) were identified from previous hospital contacts for alcoholism-related conditions or redemption of a prescription for alcohol deterrents. Data on medication use, demographics, hospital diagnoses, and comorbidity were obtained from medical databases. We computed 30-day and 3-year mortality and mortality rate ratios (MRRs) by using Cox regression analysis, controlling for covariates.
In total, 1,229 (7.3%) ICU patients were current alcoholics. Among alcoholic patients without complications of alcoholism (n = 785, 4.7% of the cohort), 30-day mortality was 15.9% compared with 19.7% among nonalcoholic patients. Compared with nonalcoholic patients, the adjusted 30-day MRR was 1.04 (95% confidence interval (CI), 0.87 to 1.25). Three-year mortality was 36.2% compared with 40.9% among nonalcoholic patients, corresponding to an adjusted 3-year MRR of 1.16 (95% CI, 1.03 to 1.31). For alcoholic patients with complications (n = 444, 2.6% of the cohort), 30-day mortality was 33.6%, and 3-year mortality was 64.5%, corresponding to adjusted MRRs, with nonalcoholics as the comparator, of 1.64 (95% CI, 1.38 to 1.95) and 1.67 (95% CI, 1.48 to 1.90), respectively.
Alcoholic ICU patients with chronic complications of alcoholism have substantially increased 30-day and 3-year mortality. In contrast, alcoholics without complications have no increased 30-day and only slightly increased 3- year mortality.